Several large cohort studies have followed women and conducted breast surveillance to those who have undergone breast augmentation. These same women were followed and their risk of breast cancer was compared to the cancer risk in women without implants or the general population. Some of the cohort studies actually demonstrated a significant reduction in cancer risk in women having undergone breast augmentation, while most other studies demonstrated a reduced breast cancer risk which did not reach significance. The cause of the observed reduction in cancer risk with breast augmentation may be related to other factors.
Clinical Breast Exams after Augmentation
Clinical breast exams may be affected by changes in the breast after augmentation. Scarring or fat necrosis can result in thickened areas or discrete palpable lumps in some patients. However implants can make it easier to detect lumps by providing a smooth and firm background against which a lesion is palpated. It has also been suggested that because women with implants may be more attentive to changes in their breasts the clinical breast exam and self breast exam is more specific and detection may occur at an earlier stage.
Mammography after Augmentation
Both silicone and saline implants create dense shadows seen on mammograms. These shadows can obsure visualization of nearby breast tissue. Optimum mammograms are obtained by maximally compressing the breast so that the X-ray beam penetrates the thinnest layer of the breast tissue. Implants are less compliant than normal breast tissue, making it difficult to achieve adequate compression.
Breast MRI after Augmentation
Breast MRI is not impaired by the presence of the implants and can be used to examine breast tissue without compression. MRI is able to demonstrate the proximity of an abnormality to the implant and may be able to detect additional areas of concern. However because of the high sensitivity of Breast MRI, this study is associated with a high false-positive rate. These false postives may lead to unnessesary additional procedures.